Welcome to the thoughts and musings of Jody DeBrege. I am not entirely sure what one should write about in an ‘about us’ section, so here goes nothing:

1. I have just turned thirty, and have gone through something of a mid-life crisis early

2. I’m single, I believe that this contributed to my mid-life crisis

3. It is really hard to find love in London

4. I work in fashion and beauty PR, it’s a horrible world full of quite bitchy people but there is a lot of free champagne.

5. the other day someone told me I should write down my thoughts, so I created a blog.

February 23, 2011, 8:44 pm

MBBS(Ceylon), DCH(Ceylon), DCH(England), MD(Paediatrics), FRCP(Edinburgh), FRCP(London), FRCPCH(United Kingdom), FSLCPaed, FCCP, FCGP(Sri Lanka) Consultant Paediatrician

Everyone knows that the teenage years can be difficult, not only for teens but also for their parents and perhaps for everybody around them. All those physical changes during puberty can make adolescents feel awkward and unsure of themselves. This is particularly true for girls when it comes to menstruation. For a girl, getting her first period is a physical milestone and a sign of becoming a woman. But it can also be confusing and scary, particularly if she encounters certain problems like irregular periods or premenstrual syndrome (PMS). most issues teens confront when they start menstruating are completely normal. in fact, many girls and even many women, have had to deal with one or more of them at one time or another.

Young girls go through puberty at different rates. Some reach menarche, which is the medical term for the first period or the beginning of menstruation, as early as 9 or 10 years old and others do not have their first periods until they are well into their teenage years. thus if a girl is a "late bloomer," it does not necessarily mean that there is something wrong with her. the time at which girls get their periods actually depends a lot on genetics and to a lesser extent, on environmental influences. Girls often start menstruating at approximately the same age their mothers or grandmothers did. Also, certain ethnic groups, on average, go through puberty earlier than others. For instance, African-American girls, on average, start puberty and get their periods before Caucasian girls do. it is advisable to seek medical attention if a girl has not got her period by age 15 or by 3 years after starting the body changes of puberty and development of secondary sexual characteristics.

Many girls experience abdominal cramps during the first few days of their periods. these are caused by a chemical in the body that makes the smooth muscle in the uterus contract. Pain resulting from these involuntary contractions can be either dull or sharp and intense. the good news is that cramps usually only last a few days. However, a medical opinion may be required if a girl has severe cramps that keep her home from school or from doing her usual activities with her friends.

It can take 2 to 3 years from a girl’s first period for her body to develop a regular cycle. during that time, the body is essentially adjusting to the influx of hormones unleashed by puberty. in fact what is "regular" with reference to periods varies from person to person. the typical cycle of an adult female is 28 days, although some are as short as 21 days and others are as long as 45. Changing hormone levels might make a girl’s period last a short time during one month, may be for just a few days and a longer time the next, perhaps up to a week or more. She may skip months, get two periods almost right after each other or alternate between heavy and light bleeding from one month to another. However, any girl who is sexually active and skips a period should see a doctor to make sure settled into a relatively predictable pattern after 3 years or if she has four or five regular periods and then skips her period or becomes irregular, one needs to get some medical advice on the problem. it is also best to let the doctor know if her cycle is less than 21 days or more than 45 days or if she does not get a period for 3 months at any time after first beginning to menstruate.

The Pre-menstrual Syndrome (PMS) includes both physical and emotional symptoms that many females get right before their periods. these include worsening acne, a feeling of being bloated, fatigue, backaches, sore breasts, headaches, constipation, diarrhoea, food cravings, depression or feeling blue, irritability, problems with concentrating and difficulty handling stress. different girls may have some or all of these symptoms in varying combinations. PMS is usually at its worst during the 7 days before the period starts and it generally disappears soon after the period begins. But girls usually do not develop troublesome symptoms associated with PMS until several years after menstruation starts. Some of them of course are lucky enough not to develop them at all. Although the exact cause of PMS is unknown, it seems to occur because of changing hormone levels and their effect on chemicals in the brain. during the second half of the menstrual cycle, the amount of progesterone in the body increases. then, about 7 days before the period starts, levels of both progesterone and oestrogen drop. Some girls’ bodies seem to be more sensitive to these hormonal changes than others.

Although most period problems are harmless, a few conditions can be more serious and require medical attention. Girls who have not started their periods by the time they are 15 – 16 years old or 3 years after they have shown the first signs of puberty have primary amenorrhea which is usually caused by a genetic abnormality, a hormone imbalance or a structural problem. Hormones are also often responsible for secondary amenorrhea, which is when a girl who has had normal periods suddenly stops menstruating for more than 6 months or three of her usual cycles. since pregnancy is the most common cause of secondary amenorrhea, it should always be ruled out when a girl skips periods. in addition to hormone imbalances, other things that can cause both primary and secondary amenorrhea include:

* significant weight loss or gain

* anorexia nervosa (amenorrhea can be a sign that a girl is losing too much weight and may have anorexia)

* stopping birth control pills

* other conditions that can affect hormone levels

Something that can also cause primary and secondary amenorrhea is excessive exercising such as distance running, ballet, figure skating or gymnastics, combined with a poor diet which usually results in inappropriate weight loss or failure to gain weight during growth. But this does not include the usual gym class or school sports team, even those that need girls to practice often. to exercise so much that she delays her period, a girl would have to train vigorously for several hours a day, most days of the week and not get enough calories, vitamins and minerals in the diet.

It is normal for a girl’s period to be heavier on some days than others. But signs of excessively heavy or long periods can include soaking through at least one sanitary napkin or pad an hour for several hours in a row or periods that last longer than 7 days. Girls with this condition known as menorrhagia, sometimes stay home from school or social functions because they are worried they would not be able to control the bleeding in public. the most frequent cause of menorrhagia is an imbalance between the levels of oestrogen and progesterone in the body, which allows the lining of the womb to keep building up. when the lining is finally shed during menstruation, the resulting bleeding is particularly heavy.

Because many adolescents have slight hormone imbalances during puberty, menorrhagia is not uncommon in teens. But in some cases, heavy menstrual bleeding can be caused by problems such as:

* fibroids (benign growths) or polyps in the uterus

* inflammation or infection in the vagina or cervix

Painful periods are referred to as dysmenorrhoea There are two types of such painful periods that can interfere with a girl’s ability to attend school, study, or sleep :-

1. Primary dysmenorrhoea is very common in teens and is not caused by a disease or other condition. Fortunately, these symptoms usually last for only a day or two.

2. Secondary dysmenorrhoea is pain caused by some physical condition like polyps or fibroids in the uterus, endometriosis, pelvic inflammatory disease (PID), or adenomyosis which is uterine lining tissue growing into the muscular wall of the uterus.

In endometriosis, tissue that is normally found only in the uterus starts to grow outside the uterus, in the ovaries, fallopian tubes or other parts of the pelvic cavity. it can cause abnormal bleeding, dysmenorrhoea and general pelvic pain.

Although most period problems are not really a cause for alarm, certain symptoms do call for a trip to the doctor. This is particularly true if a girl’s normal cycle changes. Medical advice may be sought if a girl :-

* has not started her period by the time she is 15 – 16 or her period has not become regular after 3 years of menstruating. the most likely cause is a hormone imbalance which may need treatment but this also might point to another medical problem.

* stops getting her period or it becomes irregular after it has been regular. Also one neds to let the doctor know if her cycle is less than 21 days or more than 45 days or if she does not get a period for 3 months at any time after first beginning to menstruate.

* has heavy or long periods, especially if she gets her period frequently. in some cases, significant blood loss can cause iron-deficiency anaemia. Also, heavy bleeding could be a sign of a growth in the uterus, a thyroid condition, an infection or a blood clotting problem.

* has very painful periods. having cramps for a couple of days is normal, but if a girl is not able to participate in her normal activities, one needs to get a medical opinion. She might have a medical problem such as endometriosis, causing the pain.

To determine whether a problem requires treatment, the doctor may ask several questions and do a thorough physical examination. the doctor may do a pelvic examination, take specimens for examination and perhaps perform some blood tests. if a structural problem is suspected or some sort of growth, an ultrasound or CT or MRI scan may be necessary. together, these tests can help the doctor determine how a condition should be handled. Growths such as polyps or fibroids can often be removed and endometriosis can be treated with medications or surgery. if a hormone imbalance is to be blamed, the doctor will likely suggest hormone therapy or other hormone-containing medications. For menstrual pain with no underlying medical cause, anti-inflammatory medicines are the most effective treatment. Conditions like clotting disorders or thyroid problems may require treatment with medications as well.

It is very important for parents and very specially the mothers to be aware of the many problems that daughters get before and during their periods. when one’s daughter is experiencing a particularly bad bout of PMS or cramps, the mother can help to make her more comfortable. one may suggest that the child eats a balanced diet with lots of fresh fruit and vegetables, reduce the intake of salt which can cause water retention and caffeine which can make her jumpy and anxious. the child should be given foods with calcium, which may reduce the severity of her PMS symptoms and try over-the-counter pain relievers like paracetamol for cramps, headaches or back pain. For some girls, taking a brisk walk or bike ride may relieve stress and aches and also soaking in a warm bath or a hot water bottle on the abdomen may help to relieve some of the discomfort.

If one notices that a girl’s usual periods are causing her great discomfort and interfering with her life, it may be advisable to talk to a doctor to make sure nothing else is causing the problem and to see if anything can help. Even just reassurance from a doctor may really help in dealing with the problem. Sometimes, hormone treatment can help ease many symptoms associated with uncomfortable periods. However, the most important way in which one could help a daughter feel more at ease about her period is to talk to her and explain that most annoying or uncomfortable conditions that accompany menstruation are normal and may improve over time. Parents need to show greater understanding when she is cranky and unhappy. after all, no one is at their best all the time and that includes all parents too.

= Girls start to menstruate at different ages.

= it is a sign of being a "woman"

= Quite a few of them develop the pre-menstrual syndrome

= Delay in the onset of menstruation beyond the age of 15 to 16 years needs medical attention

= Stoppage of regular periods after it has been established is also a thing to be taken seriously

= Periods associated with severe discomfort, particularly if the pain persists beyond the onset of menstruation, need to be investigated.

The writer would appreciate feedback from the readers. please e-mail him at

LONDON, January 18, 2011 /PRNewswire/ — the National Institute for Health and Clinical Excellence (NICE) today published its final appraisal determination containing final recommendations on the use of specific treatments for Alzheimer´s disease. the new ruling means Alzheimer´s patients will now have access to treatment from the earliest stage of the disease.[1]*

A survey conducted among general practitioners across the UK has suggested that the new recommendations will give Doctors[2] a strong reason to diagnose and treat this devastating disease early. it highlighted that nearly two thirds (64.1%) of GPs believe that their detection and diagnosis of mild Alzheimer´s disease patients will improve as a result of the NICE guidance. Until now diagnosing the condition early has been difficult for GPs, as the guidelines previously recommended treatment only for patients with moderate or severe Alzheimer´s disease. 70.2% of GPs surveyed believe that their management of Alzheimer´s disease will change as a result of the new guidance with over half (57.9%) of GPs stating that they would be likely to recall patients with mild Alzheimer´s previously denied treatment for reassessment. This should help more people with early disease get access to specialist care by being referred to a memory service for assessment. A total of 40.7% of doctors also thought that their prescribing of AChEIs would change as a result of the NICE recommendations.

“This is great news for people with Alzheimer´s disease and their families because we will now be able to offer effective drug treatment in mild, moderate and severe Alzheimer´s disease. for example, patients with mild disease will at last be able to get access to early, cost-effective treatment at the point of diagnosis – treatment that can potentially help to relieve the symptoms in these patients”, says Professor Roy Jones from the Research Institute for the Care of Older People (RICE), Royal United Hospital, Bath, UK. “Previously it was difficult to see patients with mild disease and ask them to come back when their condition worsened before we were able to prescribe drugs that could improve their symptoms. This new ruling will help keep patients as independent as possible for as long as possible.”

the new survey data also revealed that, unfortunately 29.6 % of GPs surveyed were unaware of the preliminary recommendations published by NICE on the use of AChEIs in patients with Alzheimer´s disease and 55.5% believe that there are inadequate protocols / materials in place to effectively help them diagnose people showing early signs of disease. In addition, the survey revealed that 86.7% of GPs believe that families and carers of patients with Alzheimer´s disease do not have adequate support to recognise and manage the early signs of the disease. it is vital that Alzheimer´s disease is diagnosed as early as possible, as having an early diagnosis, starting treatment and putting lifestyle modifications in place in the early stages of the disease can help individuals prepare for the future.[3] Greater awareness is needed amongst patients, carers and GPs of the early treatment options now available to them which could lead to better outcomes for the patient and carers.

*Additional information on the NICE guidance1

1.1 the three acetylcholinesterase (AChE) inhibitors (donepezil, galantamine and rivastigmine) are recommended as options for managing mild to moderate Alzheimer´s disease under all of the conditions specified in 1.3 and 1.4.

1.2 Memantine is recommended as an option for managing Alzheimer´s disease for people with: moderate Alzheimer´s disease who are intolerant of or have a contraindication to AChE inhibitors or severe Alzheimer´s disease.

1.3 Treatment should be under the conditions specified in 1.3.

– Only specialists in the care of patients with dementia (that is, psychiatrists including those specialising in learning disability, neurologists, and physicians specialising in the care of older people) should initiate treatment. Carers´ views on the patient´s condition at baseline should be sought. – Treatment should be continued only when it is considered to be having a worthwhile effect on cognitive, global, functional or behavioural symptoms. – Patients who continue on treatment should be reviewed regularly using cognitive, global, functional and behavioural assessment. Treatment should be reviewed by an appropriate specialist team, unless there are locally agreed protocols for shared care. Carers´ views on the patient´s condition at follow-up should be sought.

1.4 if prescribing an AChE inhibitor (donepezil, galantamine or rivastigmine), treatment should normally be started with the drug with the lowest acquisition cost (taking into account required daily dose and the price per dose once shared care has started). however, an alternative AChE inhibitor could be prescribed if it is considered appropriate when taking into account adverse event profile, expectations about adherence, medical comorbidity, possibility of drug interactions and dosing profiles.

for the full guidance, please visit: guidance.nice.org.uk/

currently, there are around 820,000 people living with Alzheimer´s and other dementias in the UK, [4] including an estimated 575,000 sufferers in England and 37,000 in Wales.[5] Alzheimer´s disease is the most common form of dementia, affecting 62% of dementia patients in the UK.[5] This irreversible, progressive brain disorder gradually destroys memory, reasoning and thinking skills, and may eventually leave patients unable to carry out even the simplest tasks.[6] Alzheimer´s disease has impacts in many ways including physical, mental, nursing, medical and social impacts.[1] despite its burden, Alzheimer´s remains a relatively overlooked disease. Just 2.5% of the government´s medical research budget is devoted to dementia; in contrast a quarter is allocated to cancer research.[7]

Eisai is one of the worlds leading research-based pharmaceutical companies that has defined its corporate mission as “giving first thought to patients and their families and to increasing the benefits health care provides, ” which we call human health care (hhc).

Eisai concentrates its research activities in three key areas:

– Integrative Neuroscience, including: Alzheimer´s disease, multiple sclerosis, neuropathic pain, epilepsy, depression – Integrative Oncology including: anticancer therapies; tumour regression, tumour suppression, antibodies, etc and supportive cancer therapies; pain relief, nausea – Vascular/Immunological reaction including: acute coronary syndrome, atherothrombotic disease, sepsis, rheumatoid arthritis, psoriasis, Crohn´s disease

With operations in the U.S., Asia, Europe and its domestic home market of Japan, we employ more than 11,000 people worldwide.

About Pfizer: Working Together for a Healthier World(TM)

at Pfizer, we apply science and our global resources to improve health and well-being at every stage of life. We strive to set the standard for quality, safety and value in the discovery, development and manufacturing of medicines for people and animals. our diversified global health care portfolio includes human and animal biologic and small molecule medicines and vaccines, as well as nutritional products and many of the world´s best-known consumer products. every day, Pfizer colleagues work to advance wellness, prevention, treatments and cures that challenge the most feared diseases of our time. Consistent with our responsibility as the world´s leading biopharmaceutical company, we also collaborate with health care providers, governments and local communities to support and expand access to reliable, affordable health care around the world. for more than 150 years, Pfizer has worked to make a difference for all who rely on us.

In the UK, Pfizer has its European R&D headquarters at Sandwich and its UK business headquarters in Surrey, and is the major supplier of medicines to the NHS. To learn more about our commitments, please visit us at pfizer.co.uk.

[1] National Institute for Health and Clinical Excellence, Final Appraisal Determination – Donepezil, galantamine, rivastigmine and memantine for the treatment of Alzheimer´s disease (review of NICE technology appraisal guidance 111)

[2] Opinion Health survey data. Total sample size was 200 GPs in the UK. Online internet-based survey fieldwork undertaken between 13th – 16th December 2010. Eisai Europe and Pfizer Ltd. Data on File

[3] Doraiswamy PM, Steffens DC, Pitchumoni S, Tabrizi S. Early Recognition of Alzheimer´s disease: what is consensual? what is controversial? what is practical? J Clin Psychiatry. 1998;59 (suppl. 13):6-18.

[4] Alzheimer´s Research Trust -Dementia 2010. Available at: dementia2010.org/reports/Dementia2010Full.pdf. Last accessed Jan 2011

[5] Alzheimer Society. Available at: alzheimers.org.uk Last accessed Jan 2011

[6] National Institute on Aging (NIA). Alzheimer´s Disease Factsheet. NIH Publication no 08-6423. Reprinted February 2010

[7] Alzheimer´s Research Trust. Available at: alzheimers-research.org.uk/info/statistics/ Last accessed Jan 2011

Eisai Europe Limited and Pfizer Limited

You might think that yet another long-haul flight is the last thing the Strictly Come Dancing judge would want to take, given he has endured a weekly commute from London to Los Angeles over the past two months.

As such he has clocked up a staggering 11,000 miles a week and a total of 768 hours in the air to appear on Dancing with the Stars, the U.S. version of the BBC dance competition. 

Bruno Tonioli (above, on holiday in the Maldives) has clocked up a staggering 11,000 miles a week and a total of 768 hours in the air over the past two months

However, if anyone can shimmy his way out of the disorientating effects of jet lag, it is Bruno.

‘It can be crippling,’ he says, ‘a huge shock to the system when the long-haul flights are so frequent. You cannot avoid jet lag but you have to be able to control it. that comes with disciplining how you spend your time during and after a flight and by learning how to cope with the psychological effects.’

It was six years ago that Bruno, 55, a dancer and choreographer from Ferrara, Northern Italy, appeared in the first series of Strictly and his mixture of exuberance and petulance was an instant hit with viewers.

In fact, such was his success that, along with fellow judge Len Goodman, he was asked four years ago to be on the judging panel of Dancing with the Stars, a commitment that required intensive travelling.

So how does he feel when he arrives back at Heathrow?

‘As if bits of my body are still arriving,’ he quips. ‘But this is how I feel for most of the time as I fly backwards and forwards. I’m forever feeling as though I’m in another dimension. But you just have to get a grip of yourself and ride it out.’

Jet lag, or to use its medical name desynchronosis, is disruption of the body clock, the brain cells that control the timing of biological functions (circadian rhythms) for when we eat and sleep. 

Silent flights: Bruno with fellow judge Len Goodman. the duo barely talk on board

Symptoms of jet lag can vary and the severity will usually depend on how far you have flown and how many time zones you have crossed.

If you travel over three or more time zones (Asia, Australasia, the Pacific Islands, U.S. and Canada or Central and South America) you will be at risk of jet lag because of the disruption caused to your body’s rhythm of daylight and darkness.

Most will have jet lag only after crossing at least three time zones, although some may experience mild symptoms after shorter journeys.

A disturbed sleep pattern is one of the most common symptoms and, although it can make you feel exhausted, you may find it difficult to sleep at the correct times. For example, you may be awake during the night and sleep during the day.

Other symptoms include indigestion-constipation, diarrhoea, nausea-loss of appetite, difficulty concentrating, feeling disorientated, anxiety, irritability, memory problems, clumsiness, lack of energy, light-headedness, confusion, headaches, sweating, muscle soreness, menstrual irregularities in women, and feeling generally unwell.

‘Travelling west  -  which I do to LA  -  is far easier to cope with than coming home east to the UK. Going to LA it’s a daylight flight and when you arrive the clock is eight hours behind UK time and so you have a longer day.

‘The body can adjust better to a longer day than the shorter one that you have when you travel east to come back here and the clock goes forward eight hours.’ 

Bruno with fellow judge Alesha Dixon on Strictly Come Dancing

So what does he recommend to beat jet lag? ‘I get my mind focused into training  -  like an athlete  -  and stick to a rigid routine of eating the right food at the right times and doing physical exercise whenever possible. But I also do my best to psychologically get on top of jet lag. I believe it is mind over matter.’

Bruno says that over the years his routine has been as rigorous as any business commuter and he believes anyone who follows his advice can beat it, too.

He makes sure he eats a big breakfast in the airport lounge and orders his favourite dish of two fried eggs on brown toast with two slices of Parma ham. the flight  -  which he takes with Goodman  -  leaves Heathrow for LA at 11.25am and the first thing he does is to put his watch back eight hours to 3.25am LA time.

‘On the outward journey I have a glass of champagne but I never drink much: there’s nothing worse than knocking back the booze as it dehydrates you. I read the papers before having anything to eat.

‘I always have a light lunch  -  salad followed by fruit  -  but no coffee, which is a diuretic and can also dehydrate you. People think Len and I while away the hours chatting on the flight and seem surprised when I say we hardly speak.

‘We are so tired having been in the studios doing Strictly on the Saturday night and then leaving for LA the following morning. After lunch I drink a litre of water to keep hydrated. After a couple of films I may take a nap. But by the time we land in LA at 3pm local time after 12 hours I feel like a zombie.

‘Getting into the airport and queuing at passport control is almost worse than being in the plane.’

After unpacking in his flat, Bruno walks in the fresh air and then does food shopping. ‘I know what I want to eat  -  usually a pasta dish which is full of carbs so it makes you sleepy.

‘Later that day I go for a meeting at the studio where we film Dancing with the Stars and by this time I’m very tired. however, I think positive and manage to keep awake  -  which is a good thing for myself and everyone else on the production.

‘After the meeting, I go home and eat my pasta at 11pm, then try and stay up for another hour at least. by then, I’m tired enough to sleep even though my body thinks it’s 8am.’

Then Bruno sleeps the night through. ‘That’s the trick, not to give in to sleep for as long as possible after you land or you wake up in the middle of the night unable to doze off again and start worrying about if you are going to be exhausted.’

The next morning Bruno spends up to an hour-and-a-half on the treadmill and doing weight-training, stretches and yoga before getting ready to go for another morning meeting.

‘Exercise gives you plenty of energy. having done my workout I feel I’m almost human again and, for the next couple of days and when we shoot the U.S. show, I am.’ 

But as Bruno and all other commuters know, flying east to come home is far harder than going west. ‘Len and I leave LA on the Wednesday-evening at 5.30pm. we regular commuters call this the “red-eye” as it can be terribly tiring if you cannot get to sleep and your eyes tell the story when you arrive.

‘I take something to help me nod off because I don’t feel very sleepy. I have dinner and then settle down.’

Despite the fact that it is classified as an illegal drug in some countries, many long-haul commuters take the hormone supplement melatonin which  -  because it’s naturally produced by the body to trigger sleep at the appropriate times  -  can decrease jet lag symptoms in those who, like Bruno, take long-haul flights.

Produced in the pineal gland  -  located in the centre of the brain  -  the melatonin signal forms part of the physiological system which creates the sleep-wake cycle by causing drowsiness and lowering the body temperature in readiness to sleep.

Melatonin has been found to lessen the time it takes to fall asleep, reduce daytime tiredness and boost alertness during the day. It is available on prescription in the UK, and online.

Some say it does not work and others report side-effects such as nightmares, headache and depression, and the jury is still out on whether it could damage the body clock.

‘I take Tylenol PM, an American over-the-counter product. It’s an antihistamine with sedating properties similar to Nytol or Benadryl in the UK. This helps me because I need that sleep on the flight in preparation for landing back in London at midday on Thursday.

‘I never give in to sleep when I’m back in the UK, despite the fact that I feel like the living dead and as though my brain and body are disconnected. I open all my mail and read my emails. You must stay awake all afternoon. This is crucial otherwise you won’t be tired enough to sleep at night. You have to ride out the jet lag. It is psychological. Just tell yourself I WILL overcome it.’

He makes sure his London routine is similar to his LA one to keep his body on an even keel.

‘I go out and do my food shopping, cook a meal and stay up until 11pm. I go to the gym the following morning and am then able to take the day off. then on Saturday I’m ready for the evening show.’

Bruno is the first to admit that signs of jet lag can make filming Strictly stressful. ‘It’s a live show so a lot of adrenaline is pumping and this means my “self-edit button” does not always kick in and I may say something ruder than I otherwise might have said.’

Bruno also has to deal with the visible symptoms of jet lag. ‘The skin becomes dehydrated and I always keep it well moisturised with Dr Hauschka’s Rose Day Cream.’

So what happens about jet lag when he’s on holiday?

‘Thailand is seven hours ahead of UK time and even though I’ll be travelling east, I’ll lie on the beach all day, reading, swimming, relaxing. But whether one is working or on holiday, there’s no point in worrying about jet lag.

‘You get on with whatever you are doing and train yourself not to keep thinking about it because jet lag is all mind over matter.’

Strictly Come Dancing Live 2011, ticketzone.co.uk

Professor Jim Horne heads the Sleep Research Centre at Loughborough University, and is professor of psychophysiology.

He believes jet lag certainly does exist and that our body clock takes time to adapt to a new 24-hour clock. if daylight and darkness and set mealtimes  -  which regulate our bodies  -  are disrupted, then our sleep patterns are disrupted too.

‘However, sleep dysfunction is also affected by state of mind. if you’re enjoying life then mind over matter is important. Lack of sleep can give you a bit of a high and if, like Bruno, you’re doing things that have a buzz, then it is amazing what the body can cope with. Excitement, rather than stress, can help combat jet lag.’

‘Yes. look at pilots who really enjoy their jobs. It all depends on how much you rely on flying and whether you have established a set routine. and then again Bruno is flying first Class with less of the stress and struggle of economy travel.’ 

An Italian dish for Bruno: Pasta with tomato sauce basil and grated Parmesan

‘Yes. It takes time for the body to adapt. Younger people can cope with it by just riding it out when they get to their destination, whereas older people pace themselves and know what’s best for them and devise strategies to help them cope.’

‘No, it’s irrelevant. if you want to adapt to your environment, get as much light at the normal daylight time as soon as possible after landing. Daylight has a very powerful effect on the body and helps the body clock to adjust.’

‘Food is up to the individual. I’m not convinced that any diet really helps cope with jet lag. Alcohol can interfere with the body clock. with dehydration from coffee and alcohol you lose body fluids that can exacerbate jet lag symptoms. the accomplished traveller has plenty of fluids.’

It is a hormone of the dark and helps shift the body clock. It facilitates sleep, helping the body to know when to sleep. For jet lag, take it two hours after sunset if going east or if waking early going west. But it’s not as powerful as natural daylight.

Welcome solution: Eating chocolate could cure a persistent cough

Chocolate could provide the key to tackling a persistent cough, researchers claim.

They are carrying out the final stages of clinical trials on a drug that contains theobromine, an ingredient naturally present in cocoa and chocolate.

If the trials are successful, the drug could be on the market within two years.

More than seven million Britons suffer from a persistent cough, defined as one that lasts for more than two weeks.

Some have asthma-like symptoms while others suffer from heartburn.

But most widely available cough products soothe the symptoms rather than deal with the cause, and have been criticised for side effects such as drowsiness.

There are safety concerns about side effects from other products that are codeine-based, which use a chemical called an opioid.

Previous research by London’s National Heart and Lung Institute found that theobromine is 33 per cent more effective than codeine at stopping coughing. It works directly on the vagus nerve, which is responsible for persistent coughing.

Research in South Korea has shown that theobromine has none of the side effects associated with standard drug treatments for persistent cough.

Professor Alyn Morice, a leading expert in the treatment of cough who is head of the Hull Cough Clinic, said: ‘Thousands of people across the UK suffer from persistent cough, and due to the drawbacks of current opioid drugs such as codeine, we are in desperate need of a non-opioid treatment with a drastically improved side effect profile for patients.’

PAYING a HIGH PRICE FOR YOUR HOT CHOCOLATE

The cost of hot chocolate drinks is set to soar, analysts predictedyesterday.

The industry has been hit by a record 32 per cent rise inthe price of cocoa powder this year.

A crop shortage and disruption tosupplies from the Ivory Coast because of a ‘chaotic’ general electionhave been blamed.

Chocolate bars and confectionery will not be affectedto the same extent, as they are made using cocoa butter, which has seena lesser rise of 11 per cent.

A research project set to begin next year will be the final phase of clinical trials of a drug called BC1036. the drug is being developed by SEEK, a leading UK privately-owned drug discovery group.

Manfred Scheske, CEO of consumer health at SEEK, said: ‘Persistent cough is a very common condition, often lasting for weeks after a viral infection. It can be difficult to treat, especially since it is not possible to give large doses of opiate-based medication to patients due to side-effect issues.

‘This drug has the potential to dramatically impact the treatment of persistent cough and could greatly benefit the quality of life of persistent cough sufferers.’